Publication:

Study of etiological factors and immediate outcomes of neonatal seizure among preterm and term neonate in a tertiary health centre of Northern India

Background Neonatal seizures result due to altered neurological functions like motor, behavioural and autonomic function. We conducted this study to assess the incidence, etiological factors, and immediate outcomes of neonatal seizures in term and preterm neonates.

Methods This prospective observational study included all neonates delivered in a tertiary health centre of New Delhi from Nov 2015 to Oct 2016 and admitted in Neonatal Intensive Care Unit with clinically identified seizures up to 28 days of postnatal age.

Results Out of 11,109 live births during the study period, 302 developed neonatal seizures with overall incidence of 2.71%. The early preterm (12.05%), very low birth weight babies (56.30%), and neonates in first 24 hrs of life (68.9%) had the highest incidence of neonatal seizures. The commonest seizure type was subtle seizures (52.3%). In early preterm commonest etiology was infection (31.3%) while in late preterm and term neonates most common etiology was Hypoxic ischaemic encephalopathy 59% and 72% respectively. Overall, HIE was the most common etiology (57%). Out of 302 cases, 81 (26.8%) cases have died. HIE was found to be the most common cause for mortality. Mortality was highest in early preterms (49.3%) and very low birth weight neonates (52.3%). Also, mortality was maximum among neonates having subtle seizures (29.1%) and seizures occurring within 24 hrs of life (30.8%).

Conclusions Persistently high incidence of neonatal seizures requires further strengthening of antenatal, natal, and post-natal health services. Early identification of neonatal seizures and timely intervention are very important for better outcomes.